Department of Physiology, Institute of Health Sciences, and Medical Research Center for Neural Dysfunction, Gyeongsang National University School of Medicine, Jinju 660-751, Korea.
Korean J Physiol Pharmacol. 2009 Dec;13(6):437-42. doi: 10.4196/kjpp.2009.13.6.437. Epub 2009 Dec 31.
A non-steroidal anti-inflammatory drug (NSAID) has many adverse effects including cardiovascular (CV) risk. Diclofenac among the nonselective NSAIDs has the highest CV risk such as congestive heart failure, which resulted commonly from the impaired cardiac pumping due to a disrupted excitation-contraction (E-C) coupling. We investigated the effects of diclofenac on the L-type calcium channels which are essential to the E-C coupling at the level of single ventricular myocytes isolated from neonatal rat heart, using the whole-cell voltage-clamp technique. Only diclofenac of three NSAIDs, including naproxen and ibuprofen, significantly reduced inward whole cell currents. At concentrations higher than 3 microM, diclofenac inhibited reversibly the Na(+) current and did irreversibly the L-type Ca(2+) channels-mediated inward current (IC(50)=12.89+/-0.43 microM) in a dose-dependent manner. However, nifedipine, a well-known L-type channel blocker, effectively inhibited the L-type Ca(2+) currents but not the Na(+) current. Our finding may explain that diclofenac causes the CV risk by the inhibition of L-type Ca(2+) channel, leading to the impairment of E-C coupling in cardiac myocytes.
一种非甾体抗炎药(NSAID)具有许多不良反应,包括心血管(CV)风险。非选择性 NSAIDs 中的双氯芬酸具有最高的 CV 风险,如充血性心力衰竭,这通常是由于兴奋-收缩(E-C)偶联中断导致心脏泵血功能受损所致。我们使用全细胞膜片钳技术,在从新生大鼠心脏分离的单个心室肌细胞水平上,研究了双氯芬酸对 L 型钙通道的影响,L 型钙通道对于 E-C 偶联至关重要。在三种 NSAIDs 中,只有双氯芬酸、萘普生和布洛芬显著减少内向全细胞电流。在高于 3 μM 的浓度下,双氯芬酸以剂量依赖性方式可逆性抑制 Na(+)电流,并不可逆地抑制 L 型 Ca(2+)通道介导的内向电流(IC(50)=12.89+/-0.43 μM)。然而,硝苯地平,一种著名的 L 型通道阻断剂,有效抑制 L 型 Ca(2+)电流,但不抑制 Na(+)电流。我们的发现可能解释了双氯芬酸通过抑制 L 型 Ca(2+)通道导致 CV 风险,从而导致心肌细胞 E-C 偶联受损。